International Student Application

In order to complete this application form, you will need to have available:

your personal information; and

a list of your post-secondary education.

Please note: this form cannot be saved and returned to later.

Degree Program to which you are applying *

Master of Divinity

Master of Arts

Anticipated Start Date

Term *

May 2015

Fall 2015

January 2016

Spring 2016

Personal Information

First Name *

Middle Name

Last Name *

Citizenship *

Country of Current Residence *

Complete Mailing Address *

Please include address, city, postal codes, and country

Telephone Number *

Email Address *

Gender

Date of Birth *

Month

Day

Year

Demographic Information

Race/Ethnic Group

Place of Birth

Marital Status

Household Members

Religious Affiliation

Faith Tradition

Congregation

If Church of the Brethren, Your District

-- If applicable:

Ministerial Status (eg. Licensed, Ordained)

Year of Ordination/Licensure

Ordaining/Licensing District or Judicatory

Educational Preparation

Please list colleges, universities, and seminaries attended, and/or other ministry training programs in which you have participated, beginning with the most recent.

Highest Level of Education Experience *

Some College Work

Bachelors Degree

Some Graduate Work

Graduate Degree

Educational Institution #1

Institution Name *

Educational Institution #1 Complete Mailing Address

Dates Attended *

Degree Achieved (if applicable) *

Educational Institution #2

Institution #2 -

Institution Name

Educational Institution #2 Complete Mailing Address

Dates Attended

Degree Achieved (if applicable)

Educational Institution #3

Institution #3 -

Institution Name

Educational Institution #3 Complete Mailing Address

Dates Attended

Degree Achieved (if applicable)

Additional Space (if needed)

Background Information

If you answer 'Yes' to any of these questions, please explain in the space provided.

Have you ever been convicted of a criminal offense? *

Yes

No

Have you ever been disciplined by a judicatory body responsible for ministerial ethics? *

Yes

No

Explanation

AFFIRMATION

By clicking "Submit," I hereby affirm that all the information contained in this application is factually correct and honestly presented. I understand that any omission or falsification of information on this application may be grounds for denial of admission or immediate dismissal. I also understand that all documents submitted for application become the property of Bethany Theological Seminary and are not returnable or transferable to any third party.

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